Individual provider Active NPI

Kristi McCluskey, PHARMD

  • Pharmacist
  • Brandon, MS
National Provider Identifier
1851997597
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E-09926 Issued in MS
Practice address
1866 Spillway Rd
Brandon, MS 39047-6063
Phone
(601) 992-4466
Fax
(601) 992-4415
NPI assigned
Dec 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E-09926 MS Primary

Addresses

Primary practice location

1866 Spillway Rd
Brandon, MS 39047-6063

Mailing address

1866 Spillway Rd
Brandon, MS 39047-6063
Phone (601) 992-4466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
E-09926MSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Polk'S Crossgate Discount Drugs Inc. PastSince Dec 13, 2020 Accepting new patients
Polks Crossgates Discount Drugs Inc Pharmacist PastSince Dec 13, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1851997597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1866 SPILLWAY RD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390476063",
            "telephone_number": "601-992-4466",
            "fax_number": "601-992-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 SPILLWAY RD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390476063",
            "telephone_number": "601-992-4466",
            "fax_number": "601-992-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLUSKEY",
        "first_name": "KRISTI",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-09926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.